Recent results in our laboratories have revealed a new and unexpected relationship between the complement system and post-menopausal bone loss, which has the potential to lead to new therapies for osteoporosis. These studies revealed that mice lacking the C3 component of the complement system were protected from bone loss after ovariectomy (OVX), as shown by micro-computed tomography (microCT) analysis. Our in vitro studies revealed that bone marrow cells from complement receptor-deficient mice had decreased capacity to differentiate into functional osteoclasts. Further, inhibition of complement signaling suppressed human osteoclast differentiation from hematopoietic progenitors. Based on these results, it is hypothesized that the complement system is a key regulator of bone balance and a potential target for the treatment of osteoporosis. To address this hypothesis, two Aims are proposed. Aim 1 will examine which complement activation pathway is involved, and how complement and complement receptor deficiency impact in vivo bone turnover by assessing bone structure in several OVXed complement knockout mice (Factor D-/-, C1q-/-, MBL-/-, C3-/-, C3aR-/- ,C5aR-/-, and C3aR-/-C5aR-/-) and wild type (WT) controls; microCT and bone histomorphometry will be the primary readouts. Aim 1 also will examine the role of local complement production in the regulation of bone balance using cross-implantation studies where mesenchymal stem cells (MSC) form ectopic bone in porous ceramic carriers. Aim 2 will test the use of complement receptor inhibitors as a means of preventing osteoporosis both in WT mice and humanized mice. WT (C57BL/6) mice, human umbilical cord blood stem cell-implanted NSG (NOD.Cg-Prkdcscid Il2rgtm1Wjl/SzJ) mice, human MSC-implanted NSG mice, and both human umbilical cord blood stem cell and MSC-implanted NSG mice will be OVXed, treated, and assessed by microCT and bone histomorphometry. A novel aspect of the Aim 1 studies is the use of ectopically formed bone from MSCs isolated from the knockout mice that are then implanted into WT mice, and vice versa, which are then assayed for histomorphometric bone parameters - this allows for determination of the role of local complement deficiency of the MSCs on bone formation and loss, and also probes the effect of complement deficiency in hematopoietic cells when WT MSCs are implanted into the complement knockout mice. The complement receptor antagonists treatment experiments in Aim 2 using WT mice and different humanized mice are the most clinically relevant, and will address the potential of using these inhibitors for treating or preventing osteoporosis in humans. These studies will clarify how diminished complement signaling affects osteoblast and osteoclast differentiation in estrogen deprivation induced bone loss. The long-term goal of these studies is to develop new therapies to treat or prevent osteoporosis. PUBLIC HEALTH RELEVANCE: This project will study the role of complement in regulating bone turnover in osteoporosis, which has the potential of opening up complement as a new target for developing novel, effective therapies against osteoporosis.